RMTA Music Camp Scholarship Application Form – Richmond Music Teachers Association

Student's Name *

First

Last

Age

Student's Address

Address Line 1

Address Line 2

City

State

Zip Code

Student's Phone

School Name

Grade

Parent's Name *

First

Last

Parent's Phone

Parent's Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent's Email *

RMTA Recommending Teacher

Instrument/Subject Studied with RMTA Teacher

Number of Years Studied

List of Other Instruments Studied, Number of Years and Teacher's Name:

Participation in Musical Organizations and Number of Years in Each:

Performances at School, Church or Other:

Music Courses Taken in School:

Musical Honors/Awards:

Date / Time

Name of Summer Music Camp to which you are applying:

Mailing Address of Camp:

Address Line 1

Address Line 2

City

State

Zip Code

Number of Weeks:

Tuition Fee:

Upload Teacher Recommendation and Student Essay:

Click or drag files to this area to upload. You can upload up to 2 files.

Name